No symptoms, no problem? Patients' understandings of non-insulin dependent diabetes.

Depth interviews were carried out with 46 people with non-insulin dependent diabetes. In the course of narrative accounts, respondents displayed their thinking about the nature of diabetes and their understandings of how one ought to respond to it. Two variations in patients' interpretations of diabetes are discussed here: the extent to which patients primarily orientated themselves toward symptom control or toward prevention of complications, and their perceptions of the seriousness of the condition. Most patients believed diabetes to be a serious condition, which could cause complications. However, many were able to reconcile such beliefs with a less than whole-hearted adherence to medical advice about lifestyle. The analysis suggests a range of specific areas of diabetes care where patients could be more fully informed. Most importantly it describes a range of ways in which patients present their non-adherence to medical advice about lifestyle as entirely rational, given their perceptions of diabetes and its personal implications for each of them. Better understanding of such perceptions by health professionals may improve therapeutic alliances.